To Increase or Not to Increase? That is the Question
To encourage more primary care providers to serve Medicaid patients at a time when Medicaid enrollment was about to increase significantly nation-wide, the Affordable Care Act raised Medicaid primary care reimbursement to the same level as Medicare rates for 2013 [...]
More Medicaid Expansion Coming?
Now that Arkansas, Pennsylvania, and Iowa have gained federal approval of Medicaid expansion proposals that call for more use of private insurers than states that simply expanded their existing Medicaid programs, it looks as if other states may follow a [...]
Innovation Center Introduces “Transforming Clinical Practices” Initiative
The federal Center for Medicare and Medicaid Innovation has launched a new, $840 million program designed to help clinicians achieve large-scale health transformation. According to the agency's news release, its “Transforming Clinical Practices” initiative …will fund successful applicants who work [...]
Medicaid Directors Weigh in On Managed Care Regulation
The nation’s state Medicaid directors have offered their perspectives to the federal government on how to modernize and regulate state Medicaid managed care programs. In a paper entitled “Medicaid Managed Care Modernization: Advancing Quality Improvement,” the National Association of Medicaid [...]
Congressman Reiterates Call for Improving Medicare Readmissions Program
Congressman James Renacci (R-OH) is again asking his House colleagues to support his proposal to adjust Medicare’s hospital readmissions reduction program. Noting that in its current form the program penalizes hospitals that care for larger numbers of poorer, sicker patients [...]
Increased Utilization by New Medicaid Patients Levels Off, Study Finds
Spikes in hospital emergency room and inpatient admissions attributed to patients who have recently obtained Medicaid coverage eventually taper off, according to a new study. According to the study Increased Service Use Following Medicaid Expansion is Mostly Temporary: Evidence From [...]
Teaching Hospitals Pitch More Residencies
With the country facing a physician shortage and the number of medical residencies capped by the 1997 Balanced Budget Act (because Medicare and Medicaid provide the primary funding for the residencies), teaching hospitals need an additional 4000 residency slots a [...]
Medicare “Doc Fix” Problem – Again
Like a case of malaria, the Medicare doc fix problem just won’t go away. On 17 occasions since Congress established the formula for Medicare payments to physicians, Congress has intervened in the application of that formula to prevent steep reductions [...]
Medicare Announces Readmissions Penalties
Medicare will impose financial penalties in FY 2015 on the majority of U.S. hospitals for excessive patient readmissions. In all, 2610 hospitals face penalties that range from one one-hundredth of one percent to three percent of all Medicare payments. Last [...]
Access to Care Lacking for New Medicaid Patients
The Office of the Inspector General of the U.S. Department of Health and Human Services (OIG) has found that even as Medicaid enrollment surges as a result of Affordable Care Act reforms, many of the newly insured are having trouble [...]
